Objective
To discuss the correlation between glutamate receptor 5 (GLUR5) and the pathogenesis of intractable temporal lobe epilepsy (ITLE), through detecting the GLUR5 expression in human with ITLE and Coriaria lactone-induced rhesus monkey temporal lobe epilepsy model.
Methods
Fifty-four patients with ITLE treated in West China Hospital between January 2007 and December 2015 were regarded as clinical case group in this study. The other 43 patients who underwent temporal lobe removal decompression surgery in the same time period due to trauma, tumor or large area cerebral hemorrhage complicated with cerebral hernia were designated as the clinical control group. Quantitive polymerase chain reaction (PCR) and Western blot methods were used to detect mRNA and protein levels of GLUR5. Western blot was also used to detect the GLUR5 protein level in the hippocampus and temporal lobe tissues of Coriaria lactone-induced rhesus monkey epilepsy model, and the result was compared with that of animal controls.
Results
Quantitive PCR results showed that the expression ratio (R value) of GLUR5 in the temporal lobe of the clinical case group to the clinical control group was 0.262, without significant difference (P>0.05), while theR value in the hippocampus was 4.896, with a significant difference (P<0.05). The amplification curve showed that the GLUR5 level in the hippocampus of the clinical case group was higher than that of the clinical control group, but the GLUR5 mRNA level in the temporal lobe tissue was not significantly changed. GLUR5 PCR amplified product electrophoresis showed that the amplified fragment was 161 bp. Western blot analysis showed that the GLUR5/actin value of the temporal lobe tissue in the clinical case group was 2.172±0.063, while the value in the clinical control group was 2.142±0.060, and the difference was not statistically significant (P>0.05). The GLUR5/actin value of the hippocampus in the clinial case group was 2.548±0.509, while it was 1.584±0.415 in the clinial control group, and the difference was statistically significant (P<0.05). The GLUR5/actin value of the hippocampus of the rhesus monkey model of epilepsy was 1.007±0.034, and it was 1.001±0.032 in the animal control group, and the difference was not statistically significant (P>0.05). The GLUR5/actin value of the temporal lobe tissue in the animal experimental group of rhesus model of epilepsy was 0.763±0.026, and it was 0.742±0.034 in the animal control group, and the difference was not statistically significant (P>0.05). The target protein bands showed that GLUR5 protein expression in the temporal lobe tissue and hippocampus of the rhesus model of epilepsy and animal controls was not significantly different (P>0.05).
Conclusions
GLUR5 participates in the pathogenesis of human ITLE by acting on the hippocampus. The expression of GLUR5 in human ITLE is abnormal, but the expression of GLUR5 is not changed in the rhesus model of epilepsy. The abnormal expression of GLUR5 may play a role in the pathogenesis of ITLE.
【摘要】 目的 探討中型和重型顱腦損傷后患者血小板（platelet，Plt）參數的變化特點及臨床意義。 方法 選取2009年3月-2010年3月腦外傷后24 h內入院的顱腦損傷患者75例作為觀察組，于傷后1、3、7、14 d采血測定Plt數量、血小板平均體積（mean platelet volume，MPV）、血小板體積分布寬度（platelet distribution width，PDW），并同時進行格拉斯哥昏迷評分（Glasgow coma scale，GCS）。同時選取60例健康體檢者，測定Plt、MPV和PDW作為對照組。 結果 觀察組傷后1、3、7 d Plt計數分別為（106.21±36.31）、（102.76±35.23）、（108.37±31.32）×109/L，較對照組[（210.41±68.56）×109/L]明顯降低（Plt;0.05）；觀察組傷后1、3、7 d MPV分別為（12.34±1.34）、（11.21±1.52）、（10.78±1.36） fL，PDW分別為（15.78±1.26）、（17.67±1.16）、（16.72±1.21） fL，均較對照組[MPV：（8.24±1.76） fL，PDW：（12.86±1.42） fL]明顯升高（Plt;0.05）；傷后14 d Plt、MPV和PDW均較對照組差異無統計學意義（Pgt;0.05）。GCS≤8分組傷后1 d Plt計數為（96.85±36.52）×109/L，明顯低于GCSgt;8分組[（123.85±35.78）×109/L]，而GCS≤8分組MPV為（12.14±1.32） fL，PDW為（18.63±1.21） fL，均明顯高于GCSgt;8分組[MPV：（9.78±1.34） fL，PDW：（16.72±1.34） fL]，差異均有統計學意義（Plt;0.05）。傷后第1天Plt與隨訪6個月GOS評分呈正相關（r=0.625，Plt;0.05）。 結論 中型和重型顱腦損傷后Plt計數明顯降低，MPV和PDW值明顯升高，且與傷情及預后有關。Plt及其參數的檢測有助于對傷情、預后的判斷。【Abstract】 Objective To investigate the platelet parameters changes and its clinical significance in medium and severe head injury patients. Methods From March 2009 to March 2010, 75 brain injury patients hospitalized within 24 h after injury were included in this study. The platelet number (Plt), mean platelet volume (MPV), platelet volume distribution width (PDW) and Glasgow coma scale were measured on the first, third, seventh and fourteenth day after injury respectively. We also measured the Plt, MPV and PDW of 60 healthy volunteers to make comparisons. Results The Plt counts were (106.21±36.31), (102.76±35.23), and (108.37±31.32)×109/L in the head injury patients on the first, third, and 7th day respectively, which were significantly lower than those in the control group [(210.41±68.56)×109/L] (Plt;0.05); the MPV and PDW values measured on the first day [MPV: (12.34±1.34) fL, PDW: (15.78±1.26) fL] and the third day [MPV: (11.21±1.52) fL, PDW: (17.67±1.16)fL] were both significantly lower than those of the control group (Plt;0.05); There was no evidence of a difference in Plt, MPV and PDW between the two groups fourteen day after injury (P＞0.05); The Plt count was (96.85±36.52)×109/L in GCS≤8 group on the first day, which was significantly lower than that of GCSgt;8 group [(123.85±35.78) fL, Plt;0.05]; However, the MPV and PDW values in GCS≤8 group [(MPV: (12.14±1.32) fL, PDW: (18.63±1.21) fL] were both significantly higher than those of GCSgt;8 group [MPV: (9.78±1.34) fL, PDW: (16.72±1.34) fL, Plt;0.05]; The Plt count was correlated with GOS score positively (r=0.625,Plt;0.05). Conclusions Medium and severe head injury patients are significantly associated with a lower Plt count and increased MPV and PDW values. The Plt parameters changes are correlated with the prognosis of patients. Therefore, the measurement of Plt parameters may contribute to the valuation of severity and prognosis, and provide new ideas for treatment of head injury patients.
